9. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the events complained about had a negative effect which the organisation has not put right. Having done so we cannot link the events complained about with the negative impact Mr A has claimed.
10. Mr A’s complaint relates to his GP Practice’s refusal to approve an application for a prescription exemption certificate. He says the Practice has not clarified why he is not eligible given his ongoing medical conditions and history. He says the Practice’s refusal to approve the applications has caused him ongoing financial difficulties as he is paying for prescription charges, and distress leading to a deterioration in his mental and physical health.
11. The Practice told Mr A was not eligible for the exemption on 24 April 2024. He then sent two medical exemption forms (a FP92A form) in June and July, both were refused by the Practice. Mr A ticked the box for: ‘a continuing physical disability which means I cannot go out without the help of another person. Temporary disabilities do not count even if they last for several months'
12. The Practice says it has to apply the NHS criteria on the basis of the information available to it. The GP reviewed Mr A’s medical records, and in their professional opinion they felt Mr A’s current conditions did not qualify for medical exemption under these criteria or any of the other categories listed on the FP92A.
13. The Practice says Mr A is able to arrange an appointment to speak with the GP to discuss their rationale for the refusal. It says Mr A is also able to discuss an exemption with specialist clinicians under which he continues to receive treatment for neurosurgery, and says he has the option to pay for ongoing prescriptions via a pre-payment certificate in the meantime.
14. The Practice says it will reconsider the decision if Mr A’s conditions change and when the diagnosis for any such condition is confirmed.
15. We have not considered in any detail whether the Practice made any errors in its initial actions or its decision to refuse the exemption.
16. That is because Mr A can arrange to speak to the Practice and GPs responsible to seek clarification on their rationale and clinical reasoning for the refusal. He could also get a second opinion via his specialist clinicians. He could ask them to approve an exemption if they thought he does meet the criteria. We have decided to take no further action on the complaint.
17. We are sorry to hear of the concerns Mr A has raised about the service he received from his GP Practice. The Practice’s refusal to approve a medical exemption certificate clearly caused him distress, and we recognise how important the complaint is for Mr A. We are grateful to Mr A for taking the time to tell us about them.